Display for dual-mode medical device

ABSTRACT

A medical device includes a display area that has a thin panel having a substantially flat front surface portion, a translucent layer on a back surface of the thin panel, a layer of text or graphics on a back surface of the translucent layer, and arranged so that the text or graphics is not visible to a user on the front side when light is not provided from inside the device housing, a switch to allow a user to select a first mode or a second mode for the device, and circuitry arranged to energize one or more light sources to provide light from behind the thin panel when the device is in the first mode, and to thereby make visible the text or graphics when the device is in the first mode.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Patent ApplicationSer. No. 61/265,309 to Ziad Elghazzawi et al., entitled “Dual-ModeDefibrillator Display,” and filed Nov. 30, 2009, the contents of whichare incorporated herein by reference.

TECHNICAL FIELD

This document relates to components for creating a user display on amedical device such as a defibrillator.

BACKGROUND

Sudden cardiac arrest (colloquially “a heart attack”) is a seriouscondition that frequently results in death. The speed with which lifesaving personnel can respond to a sudden cardiac arrest is one of themost important, if not the most important, determinant of a successfuloutcome for a victim of sudden cardiac arrest. For example, it is saidthat likelihood of surviving a sudden cardiac arrest falls ten percentfor every minute in which assistance (e.g., defibrillation or chestcompressions) is delayed. As a result, speed of response can be veryimportant to a heart attack victim.

One typical mode of treatment for sudden cardiac arrest is to “shock”the heart back into a steady beating pattern using an externaldefibrillator. Such a defibrillator commonly includes a pair ofelectrodes that are placed on the victim's chest and are connectedelectrically to a power unit. In hospitals, such a defibrillator istypically used by a “code team” that responds to “codes” issued byattending caregivers. Such teams use advanced defibrillators that theycan control for a number of parameters, such as by displaying apatient's ECG and blood oxygen level, and by letting caregivers set thepower level to be delivered to the victim and provide pacing inputs.

Such professional defibrillators, known as Advanced Life Support, orALS, defibrillators can be intimidating for other staff, includingmedically-trained staff such as shift nurses. As a result, a patient mayhave to wait for a code team to arrive even though anotherwise-competent caregiver is nearby.

SUMMARY

This document describes systems and techniques that may be used toprovide a dual-mode external defibrillator. In one mode, thedefibrillator may be used as an ALS defibrillator, and in another mode,it may be used as a Basic Life Support, or BLS, defibrillator. Thedifferent modes present substantially different “looks” to a user, wherethe BLS mode provides a simplified device or interface, as compared tothe ALS mode.

Certain indicators that are lit by the defibrillator and are visiblefrom the front of the defibrillator may be concealed during BLS mode sothat a caregiver with a lower level of training will not be distractedor intimidated by such indicators. The indicators may include, forexample, lights that indicate whether the defibrillator is currentlyanalyzing a patient's readings and/or is charging a defibrillatorcircuit. The indicators may also be integrated with buttons on thedevice, so that the user can see that the buttons are available forselection when the device is in ALS mode, but not see the buttons at all(and the buttons are not available for selection) when in BLS mode. Suchselective display of the indicators can be provided using a speciallyprinted label between the front surface of the defibrillator and lightsources that back-light the label. Specifically, text or graphics can be“dead fronted” by placing a layer having a comparatively darktranslucent ink on it in line with the text or graphics on anotherlayer. In this manner, the text or graphics is hidden from being seenfrom the front of the device until substantial light is provided frombehind the text and graphics, from inside the defibrillator housing.LEDs placed inside the housing may be connected so as to be energizedwhen the defibrillator is in ALS mode, so that the enhanced ALScapabilities of the device can be announced simultaneously to a user.

Implementations of these features may provide for one or moreadvantages. For example, BLS capabilities may be provided convenientlyin a hospital setting so that immediate on-site caregivers can provideimmediate defibrillation to a patient who suffers a sudden cardiacarrest. The further capabilities of an ALS mode, including physicaladjustment mechanisms, may be hidden in BLS mode so that such acaregiver may readily provide therapy to a patient, and not bedistracted by options that are not of interest to them. Also, a singledefibrillator may be used for both BLS and ALS purposes. As a result, ahospital need not buy or store as many defibrillators, and a ward willbe less cluttered with equipment, so that the defibrillator can be keptcloser to a patient as a result (though the hospital may purchase moredefibrillators in the end, if they become particular useful. Also, thedefibrillator may provide both BLS and ALS functionality, and may switchbetween the two modes essentially seamlessly. For example, a shift nursecould start a defibrillator in BLS mode and provide immediate care to apatient suffering from sudden cardiac arrest, and when the code teamarrives, it could switch the unit to ALS mode for more detailedtreatment of the patient. Such a switchover can be achieved withouthaving to remove and replace electrodes that the initial caregiverapplied, so that the patient can receive basic care very quickly and canshift to more advanced care quickly also. As a result, the patient'schance of survival may be maximized.

In one implementation, a multi-mode electronic medical device isdisclosed that comprises a device housing that defines a front side ofthe device that is positioned to be visible to a user of the deviceduring use of the device, a display area comprising a thin panel havinga substantially flat front surface portion along the front side of thedevice, and a translucent layer behind, and aligned with, the thinpanel. The device also comprises a layer of text or graphics behind, andaligned with the translucent layer, and arranged so that the text orgraphics is not visible to a user on the front side of the device whenlight is not provided from inside the device housing, and a switch toallow a user to select a first mode or a second mode for the device.Moreover, the device comprises circuitry arranged to energize one ormore light sources to provide light from behind the thin panel when thedevice is in the first mode, and to thereby make visible the text orgraphics when the device is in the first mode.

The first mode can be an advanced life support mode and the second modecan be a basic life support mode for a defibrillator. The translucentlayer can include a velvet textured polyester film. Also, the switch canbe connected to be operated by user by a physical knob that may begrasped by the user and that is located adjacent to the display area.Moreover, the display area can be made visible to a user of the devicein the first mode and the second mode, but text is visible in thedisplay area only in the first mode.

In some aspects, the device also includes one or more push buttonswitches positioned behind the thin panel, and wherein the thin panel isflexible to permit a user to depress the one or more push buttonswitches by pressing on the thin panel. The switches can be mounteddirectly to a circuit board that is located inside the housing andbehind the thin panel. The device can also include a plurality of lightemitting diodes mounted to the circuit board, aligned to provide lightthough the layer of text or graphics, and controlled to be lit only whenthe device is in the first mode. In addition, the device can comprise afront panel frame that supports the thin layer and defines a pluralityof opaque compartments, wherein each opaque compartment corresponds to aportion of the thin layer that overlies the opaque compartment and thatis substantially light tight from others of the opaque compartments sothat lighting of one compartment does not result in lighting of othercompartments. And is certain aspects, the circuitry comprises amicroprocessor and associated memory programmed to provide advanced lifesupport functionality with the device when the device is in the firstmode, and to provide basic life support functionality and to de-energizethe one or more light sources when device is in a second mode.

In another implementation, a method of operating a multi-modedefibrillator is disclosed. The method comprises receiving a user inputto operate the defibrillator in a basic mode, interacting with the userwithout energizing lights for showing advanced features of thedefibrillator, receiving a user input to operate the defibrillator in anadvanced mode, lighting light sources through a layer of printed text orgraphics, a translucent layer, and a thin transparent or translucentface layer that is arranged so that the text or graphics is not visibleto a user of the defibrillator when the light sources are not lit, andinteracting with a user in the advanced mode. The user input can bereceived by turning a switch from a first position to a secondpositions. The method can also include receiving one or more usercontacts with areas in which light is provided by the light sources,actuating switches in response to the user contacts, and alteringoperation of the defibrillator in the advanced mode in response toactuating the switches.

In some aspects, the actuated switches are mounted directly to a circuitboard that is located inside a housing of the defibrillator and behindthe printed text or graphics. Also, the light sources can be lit underthe control of a microprocessor and associated memory programmed toprovide advanced life support functionality with the defibrillator whenthe defibrillator is in the advanced mode, and to provide basic lifesupport functionality and to de-energize the one or more light sourceswhen defibrillator is in the basic mode.

In another implementation, a multi-mode external defibrillator isdisclosed that comprises a defibrillator housing having a front side,and defining a front face that faces the front side and is positioned tobe visible to a user of the defibrillator during use of thedefibrillator, and a display area comprising a thin panel having asubstantially flat front surface portion that faces the front side. Thedefibrillator also includes a switch to allow a user to select a firstmode or a second mode for the defibrillator, circuitry arranged toenergize one or more light sources to provide light from behind the thinpanel when the defibrillator is in the first mode and means forpreventing text or graphics in the display are from being visible to auser of the defibrillator while the defibrillator is in the second mode,but to make the text or graphics in the display visible to the userwhile the defibrillator is in the first mode.

The details of one or more embodiments are set forth in the accompanyingdrawings and the description below. Other features and advantages willbe apparent from the description and drawings, and from the claims.

DESCRIPTION OF THE FIGURES

FIG. 1A shows a front of a dual-mode defibrillator in Basic Life Supportmode.

FIG. 1B shows a front of a dual-mode defibrillator in advanced lifesupport mode.

FIG. 2A shows a control panel of a dual-mode defibrillator in the offposition.

FIG. 2B shows a control panel of a dual-mode defibrillator in automaticmode.

FIG. 2C shows a control panel of a dual-mode defibrillator in manualmode.

FIG. 3 shows an exploded view of a control and display panel for adual-mode external defibrillator.

FIG. 4 shows a cross-section of a lighting mechanism for a display on amedical device.

FIG. 5 is a schematic diagram of a lighting circuit for a dual-modemedical device.

FIG. 6 is a schematic diagram of a general computing system that can beemployed to operate a medical device in manners like those discussedhere.

DETAILED DESCRIPTION

This document describes mechanisms by which a medical externaldefibrillator can provide interaction in both a BLS mode and an ALSmode. The techniques described here provide for convenient operation inBLS mode so that a relatively untrained user can operate thedefibrillator. For example, features that may be desirable in an ALSmode can be hidden from a user in the BLS mode so that the user is notoverwhelmed or confused. Certain such features may be manifested byphysical objects that a user may manipulate to affect the operation ofthe defibrillator, and because they are physical, they must be concealedphysically (e.g., by placing a cover over them) rather thanelectronically (e.g., by not displaying them on a screen).

As one example, certain notification or warning messages can be hiddenfrom a user of a defibrillator when the defibrillator is in BLS mode.Those messages may simply indicate a status of the defibrillator, andcan also represent buttons that a user may select on the defibrillatorwhen it is in ALS mode but not when it is in BLS mode. Also, certainphysical controls can be covered when the defibrillator is in BLS mode,such as knobs that a user turns to adjust the energy level delivered bythe defibrillator—such knobs may have no meaning to a caregiver who isnot especially trained for emergency life support. A latching mechanismfor a door that covers the knobs may be connected to a mechanism that isused to switch the defibrillator from BLS mode to ALS mode (or, forexample, to a pacing mode within ALS mode), so that the latchingmechanism is caused to “kick” the door open and out of the way when theswitching mechanism is moved by a user (e.g., by a highly trainedcaregiver who is taking over from a less-trained caregiver). Both ofthese mechanisms—electronic transitions and mechanical transitions—maybe used to provide a convenient, and essentially automatic, transitionfrom partly-featured BLS mode to fully-features ALS mode.

FIG. 1A shows a front of a dual-mode defibrillator 102 in basic lifesupport mode. FIG. 1B shows a front of the same dual-mode defibrillator102 in advanced life support mode. Each figures shows the front surfaceof the defibrillator 102, with a number of features that can be seen bya caregiver when they are operating the defibrillator 102. The status ormode of the defibrillator 102 can be seen by a user, for example, fromindicator 122 in FIG. 1A, where it is indicated that the device is onand is usable as an automated external defibrillator, or AED, which is aBLS mode. In FIG. 1B, many additional indicators and controls are shown,as the device has been changed to an ALS with Pacer mode by rotatingknob 116 counterclockwise two spots to the “PACER” indication.

Referring now more specifically to items that are visible under bothmodes for the defibrillator 102, there is shown an electronic display104, which may take the form of a cathode ray tube (CRT), liquid crystaldisplay (LCD) panel, organic light emitting diode (OLED) panel, or otherappropriate electronic display technology, that is preferably capable ofproviding both textual and graphical information to a user of thedefibrillator 102 in a dynamic manner. In BLS mode, for example, thedisplay 104 may be relatively unadorned, and may provide text to guide auser through the process of providing life support to a victim. Forexample, the display 104 may instruct the user textual or via simplifiedgraphics to apply electrodes to the patient, to perform CPR, and to pushharder or softer, or faster or slower, as the case may be, when they areproviding chest compressions to the victim (as sensed, e.g., via anaccelerometer that is provided in an assembly with the electrodes, andthat the user push, within a housing, against the victim's chest whendelivering chest compressions). Such instructions on the display 104 mayalso be accompanied by verbal instructions provided by a speaker in thedefibrillator 102. The unit may enter BLS mode automatically when it ispowered up, and then may be changed to ALS mode (and pacing mode) by anuser.

In ALS mode, the display 104 may provide additional, and sometimes verydetailed, information to the user. For example, the display may shown aECG for the patient, a graph of CPR chest compressions over a past setperiod of time, the total elapsed time of performing CPR, the victim'spulse, and information about the electrode pads applied to the patent.

In addition, the lower edge of the display 104 may exhibit textual orgraphical labels that correspond to a row of selection keys 114 (softkeys) that are arrayed below the display 104. Thus, for example, the rowof labels may make up a menu of topics that a user may select bypressing an associated aligned key in order to see additionalinformation about the defibrillator 102, or to change parameters forcontrolling the defibrillator 102.

Next to the selection keys 114 is an non-invasive blood pressure (NIBP)button 112. Selection of this button may allow the defibrillator 102 tomeasure a victim's blood pressure, which may in turn be shown on thedisplay 104.

A number of additional indicators are displayed in both modes along thetop of the defibrillator 102. For example, a battery indicator 106 maybe made to light or blink to indicate to a user when battery reservepower is running low, so that the user may adjust their treatment of avictim accordingly or can seek out an AC power source for thedefibrillator 102. Also, the battery level may be shown on an icon, suchas by showing the image of the battery being “filled” to a degree thatcorresponds to the level of remaining battery power, a technique that isfamiliarly used on cellular telephones. In one implementation, a steadyyellow indicator shows that the battery is charging, a steady greenindicator shows that the battery is charged, and an alternating yellowand green indicator shows that no battery is installed or there is abattery charging fault.

In a similar manner, an AC power indicator 108 may be lit when thedefibrillator 102 is plugged into an AC power source. The indicator maybe visible, but not lit, when the defibrillator 102 is not plugged in,so that a user of the defibrillator 102 can know about the ability toplug the defibrillator 102 into a power source.

A code readiness indicator 110 is lit when the defibrillator 102 isready for operation, based on a most recent self-diagnostic run. A greencheck mark indicates that the unit is ready for therapeutic use, while ared “X” indicates the defibrillator's 102 readiness is compromised andthat it may not be ready for therapeutic use.

A mode selector knob 116 can be grasped by a user of the defibrillator102 and rotated to select a mode in which to operate the defibrillator102. The knob may typically be located in an “OFF” position (asindicated by an arrow indicator on a spine of the knob 116). In FIG. 1A,the knob has been turned clockwise by a user to point toward an “ON”position, in which the defibrillator 102 operates as an semi-automaticAED, as indicated by AED indicator 122.

As can be seen in FIG. 1A, the user interface in this BLS mode is veryspartan. A user is expected in such a mode not to have substantialtraining, and thus not to need precise control over the defibrillator102. Thus, the display 104 may provide sufficient direction to the user,perhaps in combination with audible instructions. Also, in this example,the user is not even shown an option for another mode to which to turnthe defibrillator 102.

In FIG. 1B, the user has rotated the knob 116 counterclockwise past the“OFF” position, to a heretofore hidden “PACER” position, which may bepart of a manual ALS mode for the defibrillator 102. A user who wouldwant to be able to use an ALS mode and would be capable of using such amode may be presumed to have been highly trained and thus to have beenvery familiar with the defibrillator 102 and know that the mode isavailable (though the mode could be indicated on the defibrillator 102also).

A number of changes can be seen to have occurred in response to the userchanging the mode to the ALS mode. For example, a display area above theknob 116 appeared blank when the defibrillator 102 was in BLS mode. Now,however, with the defibrillator 102 in ALS mode, the display area has anumber of labels that are visible on it, because, when the user switchedthe knob 116 to ALS mode, a microprocessor and related circuitry in thedevice enabled a number of features that are relevant to ahighly-trained rescuer, but are not relevant to a less trained rescuer.For example, the display area may show information, including inuser-selectable areas, for parameters relating to the level of energyapplied to the defibrillator 102 electrodes, and relating to reading of,and control of, ECG-related functions.

Also, a pacer cover 124 that previously covered two adjustment knobs134, 136 in the lower corner of the defibrillator 102 has pivoteddownward and below the defibrillator 102 housing so as to expose theknobs 134, 136. Knob 134 controls the power output of electrodesattached to the defibrillator 102 when they provide a pacing output.Knob 136, when pacing is selected, sets the rate (pulses per minute) atwhich the pacemaker will operate. The selected pace rate setting is thenindicated on the display 104.

The defibrillator 102 may also be provided with additional componentsthat are not visible in these views of the front of the defibrillator.For example, packaged electrodes and associated feedback mechanisms(e.g., a accelerometer-based displacement measurement system) may beattached physically to the side of the defibrillator 102 and may bepre-attached electrically to the defibrillator 102 so as to permitfaster deployment of the defibrillator 102 in an emergency situation.Also, a strip chart recorder may be included inside the housing for thedefibrillator 102, as may electronic recording mechanisms and componentsfor transferring the electronic data, such as a USB port, WiFi wirelessinterface, and the like.

FIG. 2A shows a control panel of a dual-mode defibrillator in the offposition. FIG. 2B shows a control panel of a dual-mode defibrillator inautomatic mode. FIG. 2C shows a control panel of a dual-modedefibrillator in manual pacing mode. In general, these figures show thecontrol panel area of the defibrillator 102 shown in FIGS. 1A and 1B,when the defibrillator 102 is off, in AED or BLS mode, and manual or ALSmode with pacing, respectively.

Referring to FIG. 2A, a mode setting knob 204 is directed to an “OFF”position 206. In this position, the defibrillator is powered off, andonly standard automatic diagnostic features are enabled on thedefibrillator. Also, a display area above the knob 204 is blank, and apacing cover 202 is closed across the front of the defibrillator.

In FIG. 2B, the knob 204 has been turned clockwise by a user of thedefibrillator to the “ON” position. As a result, an indicator on thedisplay area has been lit so as to show text that has been printedbehind a front surface of the display area with the letters “AED.” Suchtext is intended to communicate that the defibrillator is operating, inthat mode, as an automatic external defibrillator. The pacing cover 202is also still closed, as a user of an AED need not take advantage ofsuch functionality, and would likely be confused regarding what they aresupposed to do with it, if it were shown to them. Thus, this view of thecontrol panel for a user of the device in BLS or AED mode is simple, sothat the user can focus on providing basic care for a victim, until moreadvanced caregivers arrive.

In FIG. 2C, a user has switch the defibrillator to ALS mode with pacing(though the knob 204 is still shown as pointing to the “ON” position,and would typically switch to ALS before the or when the user rotatesthe knob 204 counterclockwise so that it points to the “PACER”position).

In this mode, an “ENERGY SELECT” indicator 216 is displayed for thefirst time, with two underlying buttons that a user can select. Theindicator 216 and buttons allow a user to control the level ofdefibrillator energy that is delivered by the defibrillator when a shockis delivered. The current level may be reflected on an electronicdisplay such as display 104. Thus, a user may place their right hand atthe edge of the defibrillator and squeeze to place their thumb on eitherthe up arrow to increase the energy level, or the down arrow to decreasethe energy level. As explained more fully below, a switch may beprovided behind the area that the user presses, and light may beprovided around the switch. Such light may cause the indicator 216 totransition from essentially invisible to a user from the front of thedefibrillator, to fully visible when it is lit.

Indicator 214 shows “ANALYZE” and “CHARGE” options that can be selectedby a user pressing on the rectangles that are revealed when lightsbehind the indicators 214 are lit. When a user presses the CHARGEbutton, the defibrillator charges to the selected energy. Another chargebutton may also be placed off the main defibrillator housing, such as onan electrode paddle handle. When a user presses the ANALYZE button, thedefibrillator initiates an ECG analysis to determine whether or not ashockable rhythm is present in a victim.

A row of four other indicators 212 allows for further control in amanual or ALS mode, by a presumably advanced and extensively-trainedcaregiver user. For example, a LEAD indicator/button selects the ECGsource that is to be displayed and printed. Pressing this buttonsequentially selects ECG signals derived from various different leadconfigurations for display. The SIZE indicator/button selects theamplitude scale by which the ECG will be displayed on the electronicdisplay for the defibrillator. Available sizes can include, for example,0.5, 1, 1.5, 2, and 3 centimeters per mill volt (cm/mV).

The ALARM SUSPEND indicator/button activates, deactivates, or audiblysuspends all alarm functions. A bell symbol appears on an electronicdisplay of the defibrillator when alarms are enabled. When alarms areeither audibly or permanently disabled, an “X” appears across the bellsymbol.

The RECORDER indicator/button starts or stops a strip chart recorderthat is provided with a defibrillator. Pressing and holding the buttoncan switch a defibrillator to diagnostic ECG bandwidth (0.05-150 Hz),and such diagnostic bandwidth may be maintained as long as the RECORDERindicator/button is held down. When the indicator/button is released,the unit reverts to standard monitoring bandwidth.

Thus, by these mechanisms, an initial user may be directed to turn theunit to the ON position because that is the only option that isinitially shown to be available to them. A subsequent, more completelytrained user may then switch the device to manual mode (and pacingmode), to cause the extra indicators to be displayed under a flat frontpanel display, and to cause certain switches or buttons that correspondto display locations to be monitored for use input.

FIG. 3 shows an exploded view of a control and display panel for adual-mode external defibrillator. In general, the figure showscomponents that may be employed behind the face of a defibrillator 300in the display area shown in FIGS. 1A, 1B, and 2A to 2C. Such componentsmay be used to prevent a user of the defibrillator 300 from seeingcertain indicators and related buttons when the defibrillator 300 is ina first mode, but to display the indicators when the defibrillator 300is in a second mode, and when light from inside the defibrillator 300housing is being transmitted through the face of the display area on thefront of the defibrillator 300.

Each of the relevant layers that make up the assembly here will now bediscussed, moving from the front of the defibrillator 300 on the left tothe inside of the defibrillator 300 housing on the right. The firstcomponent in this example is a front panel overlay 302. The overlay 302may be a multi-layered assembly that includes a thin, relatively flatcover layer such as in the form of a transparent or semi-transparentplastic film or sheet. The cover layer may be backed by avelvet-textured polyester film or similar selectively-transmissivematerial. On the back of the selectively-transmissive layer, an inked orsimilarly constructed layer may be provided that defines text orgraphics to be displayed to a user when the compartment is provided withlight. In this manner, the text or graphics may be hidden when a backinglight is not applied to them, in a “dead front” arrangement, and may bevisible to a user when light is applied to the back of the overlay 302.

Behind the overlay 302 is a front panel 304. The panel 304 serves tostabilize the overlay, which is flexible, so that it is presented to auser as a relatively flat surface, but so that areas of the overlay canbe pressed by a user and depressed slightly to make selections on thesurface of the overlay 302. The panel 304 may be an injection molded,relatively rigid, plastic structure that is interrupted in particularlocations by through-holes. The through-holes may be positioned so as tocorrespond to buttons that are represented on the face of the displayarea of the overlay 302, so that light can pass through the panel 304 insuch areas, and a user's inputs may be transmitted back to buttons orother structures via the through-holes into the housing of thedefibrillator 300.

A number of flexible tiles 306 may be provided on one or more sheetsgenerally behind the panel 304, but may extend forward through the holesin the panel and be close to, or in contact with, the back side of theoverlay 302. The flexible tiles 306 may be made out of alight-transmissive material such as silicone. The panel 304 may alsoserve to diffuse light that enters it from behind, so that graphics ortext displayed to a user on the front of the overlay 302 is more evenlylit.

A flexible circuit board 308 is mounted behind the flexible tiles 306,and may have mounted on it a plurality of light emitting diodes 314. Thediodes 314 may be controlled via a microprocessor, memory, and relatedcircuitry and software in the defibrillator 300 so as to light atappropriate times, including with a dependence on the mode in which auser has placed the defibrillator 300. Such lighting may be madeaccording to the standards shown in the figures above. The flexiblecircuit board 308 may take a variety of appropriate forms, and may beinterrupted by various openings in the board where force from a usercontacting the front of the overlay 302 may be passed readily tocomponents in the assembly that are further back in the housing for thedefibrillator 300 than is the flexible circuit board 308.

Behind the flexible circuit board 308 is an inner frame 310 that, likethe front panel 304, is a relatively inflexible injection molded plasticcomponent that serves to support the flexible circuit board 308 frombehind, and also has included in it various actuators 316. The actuators316 are elongated structures that are located in each of the holes ofthe frame 310 that are aligned with user-selectable buttons on the frontof overlay 302. The actuators 316 operate to transmit the force of auser pressing one of the buttons back to pushbutton switches 318 mountedon a circuit board 320 at the back of the assembly. In this manner, theuser can obtain favorable feedback and a relatively long throw inpressing selections on the overlay 302, and in certain situations may beprovided with clicking or other particular tactile feedback when aselection has been made successfully. Also, an electronic feedbackmechanism, such as a vibration or an audible sound on a speaker of thedefibrillator 300, may also be provided when a selection has beenrecognized by the defibrillator 300, in coordination with amicroprocessor that registers the selection.

The circuit board 320 may carry a variety of components in addition tothe switches 318. For example, light emitting components for theindicators at the top of the defibrillator 300, above the display area,may be provided on the circuit board 320. In addition, various logiccircuit, memory, and processors may, in appropriate implementations, bemounted on the circuit board 320. Also, the circuit board 320 may beinterrupted in various locations, such as to permit for the positioningof knobs that are accessible from the front of the defibrillator 300around the area of the various lighted displays that have just beendiscussed.

Finally, next to the adjustment knobs and the assembly just described isa front panel display 312, which may take the form, for example, of anLED, LCD, OLED, or similar active display, which may provide to a usercolor graphics that represent instructions to the user and real-timeparameters of the defibrillator. The information displayed on thedisplay 312 may be coordinated with the selected mode of the device sothat, for example, the display 312 shows only basic instructions whenthe defibrillator is in BLS mode, and shows more complete data when thedefibrillator is in ALS mode.

In this manner, a composite user interface may be provided to a user ofa defibrillator, where the interface may include any appropriatecombination of active display (which may be a touchscreen display),user-graspable knobs and/or switches, solid user-selectable buttons, andlit-from-behind indicators and/or buttons that display information to auser when the defibrillator is in one mode, but does not show theinformation to the user when the defibrillator is in another mode ormodes.

FIG. 4 shows a cross-section of a lighting mechanism 400 for a displayon a medical device. The lighting mechanism 400 may include a sub-set ofthe components shown in FIG. 3, and are shown here in cross-section fromabove, as the components would be mounted in a defibrillator housing.

Starting from the front of the assembly 400 at the top of the figure,there is a front panel overlay 402. The overlay 402 may include aplurality of layers in order to provide a display that cannot be seenfrom the front of the overlay when no light is generated behind theoverlay, but that is visible when light passes up through the overlay402. For example, a first layer may simply be a transparent or mostlytransparent plastic sheet, which may be as thin as a film or relativelythicker so as to provide appropriate sturdiness and user feel for a userwho presses against the overlay 402 in order to activate a feature on adefibrillator or other medical device. The first layer may be backed bya velvet textured polyester film or similar selectively-transmissivematerial that provides for a “dead front” on the medical device when nolight is provided within the particular compartment, i.e., a user cansee at most a very faint representation of any text or graphics that areeasily visible when a light is provided within the compartment.

On the back of the selectively-transmissive layer, an inked or similarlyconstructed layer may be provided that defines text or graphics to bedisplayed to a user when the compartment is provided with light. Forexample, the layer may show an icon to a user that indicates a status orparameter of the defibrillator. The layer may also include text thatprovides additional notification to a user, including an indication thatthe parameter can be affected by the user pressing on the particulararea. For example, an icon shaped like an arrow may indicate to a userthat pressing on the icon will cause a related parameter to be increasedor decreased by a microprocessor that is operating on the device.

A front panel 404 is provided to support the overlay and also to definea plurality of essential light-tight compartments, where eachcompartment corresponds to a key and/or indicator area on the front ofthe device. The compartments may, in particular, enable selectivevisibility of particular areas on a front panel of a display like thedisplay on front overlay 302 in FIG. 3, based upon selective energizingof light sources behind the display.

The compartments in the front panel 404 may be filled with respectiveportions of silicone tiles 412, so that light can pass through the tiles412 and thus through the openings and compartments in the front panel404. The silicone tiles may be provided, on the back edges (at thebottom of FIG. 4) with a reflective layer made of paint or a reflectivefilm (e.g. white Mylar) that is adhesively applied to the silicone. Thereflective layer causes light that enters the silicone tiles 412 to bereflected forward through the compartments through overlay 402 and outthe front of the device so that a user of the device can view text orgraphics that are on the overlay 402. Also, paint pigment may beprovided within the silicon tiles 412 to further enhance dispersion ofthe light within the tiles 412 so as to provide a more even lighting ofthe various areas that overlay the compartments, and which the user cansee from the front of the device.

LED lights 406 or other similar light sources are provided on each sideof a silicon tile 412 so that, when the LED lights 406 are energized,their light can enter the tile 412 from the sides that are in front ofthe reflective layer, and the light may then be directed upward throughthe overlay 402 so that a user of the device can see the printedgraphics and text, as appropriate. The lights 406 may be shared betweencompartments or blocked between compartments as appropriate to provide auser with a proper interface, and so that functions that are notcurrently available on the device (in its currently-selected operationmode) are not shown to a user of the device. In this example, the lights406 are mounted directly to the front of a circuit board 408 whichcarries electrical energy to the lights.

In other embodiments, a central light source may be provided and lightpipes or other similar structures may be provided to direct light to anappropriate compartment. Light valves may also be provided in suchsituations so as to control which compartments receive light. Amicroprocessor on a device may coordinate the switching of such valvesor the powering of lights 406 so as to provide for an appropriate userinterface that is coordinated with the current feature set of adefibrillator or other medical device.

An actuator 410 is positioned behind the silicon tile 412 and is pusheddownward when a user of the device pushes on the front of the overlay402 in the position located over the appropriate compartment. Theactuator 410 may be connected directly to a switch that is actuated bythe user pressing downward in the appropriate zone, or may be in contactwith the switch. The actuator may be guided and held in place by astructure such as the inner frame 310 of the defibrillator 300 in FIG.3.

In this manner, a “dead front” display may be provided on a portion of amedical device such as a defibrillator. The dead front may be dead whenthe device is in a first mode, such as a basic operational mode that isdesigned for relatively untrained users, and may be lit up and activewhen the device is in a second mode, such as an advanced operationalmode that is designed for relatively highly trained users.

FIG. 5 is a schematic diagram of a lighting circuit for a dual-modemedical device. In this example, LEDs are organized into four groups.The first group, involving AED light 512, lights the wording of “AED” onthe front of a defibrillator when the defibrillator is in AED, or BLS,mode. The second group, consisting of lead light 502, size light 504,alarm suspend light, and recorder light 508, are energized orde-energized in unison, and are lit when the defibrillator is in manualor ALS mode. The third group, consisting of the analyze light 510,charge light 514, and energy select light 516, are lit when thedefibrillator is in manual mode. The fourth group, which is the pacerlight 518, is lit—in addition to the lights in the second and thirdgroups, when the device is in the pacer mode. Each of the sets of lightsmay be energized under the control of a microprocessor operating in amedical device (in cooperation with memory, and instructions stored inthe memory and executed by the microprocessor) in a manner that thelights are energized when the device is in an appropriate mode—where themode is responsive to inputs or outputs corresponding to the litfeatures when those features are lit, and is not responsive when thefeatures are not lit.

Power to the lights, when it is supplied, is supplied in alternating 5ms increments, as shown in the figure. Certain of the lightingsub-groups include alternating subgroups of LEDs, provided incombination with switching functionality, and the switching of thecontrol voltage is switched quickly enough that the human eye does notdiscern the switching.

FIG. 6 is a schematic diagram of a computer system 600. The system 600can be used for the operations described in association with any of thecomputer-implement methods described previously, according to oneimplementation, such as in changing the electronic mode of a medicaldevice and presenting information on a display screen of an electronicdevice. The system 600 may take a variety of general forms, as shown,though its preferred form here is as a portable medical device.Additionally the system can include portable storage media, such as,Universal Serial Bus (USB) flash drives. For example, the USB flashdrives may store operating systems and other applications. The USB flashdrives can include input/output components, such as a wirelesstransmitter or USB connector that may be inserted into a USB port ofanother computing device. The system 600 includes a processor 610, amemory 620, a storage device 630, and an input/output device 640. Eachof the components 610, 620, 630, and 640 are interconnected using asystem bus 650. The processor 610 is capable of processing instructionsfor execution within the system 600. The processor may be designed usingany of a number of architectures. For example, the processor 610 may bea CISC (Complex Instruction Set Computers) processor, a RISC (ReducedInstruction Set Computer) processor, or a MISC (Minimal Instruction SetComputer) processor.

In one implementation, the processor 610 is a single-threaded processor.In another implementation, the processor 610 is a multi-threadedprocessor. The processor 610 is capable of processing instructionsstored in the memory 620 or on the storage device 630 to displaygraphical information for a user interface on the input/output device640.

The memory 620 stores information within the system 600. In oneimplementation, the memory 620 is a computer-readable medium. In oneimplementation, the memory 620 is a volatile memory unit. In anotherimplementation, the memory 620 is a non-volatile memory unit.

The storage device 630 is capable of providing mass storage for thesystem 600. In one implementation, the storage device 630 is acomputer-readable medium. In various different implementations, thestorage device 630 may be a floppy disk device, a hard disk device, anoptical disk device, or a tape device. The input/output device 640provides input/output operations for the system 600. In oneimplementation, the input/output device 640 includes a keyboard and/orpointing device. In another implementation, the input/output device 640includes a display unit for displaying graphical user interfaces.

The features described can be implemented in digital electroniccircuitry, or in computer hardware, firmware, software, or incombinations of them. The apparatus can be implemented in a computerprogram product tangibly embodied in an information carrier, e.g., in amachine-readable storage device for execution by a programmableprocessor; and method steps can be performed by a programmable processorexecuting a program of instructions to perform functions of thedescribed implementations by operating on input data and generatingoutput. The described features can be implemented advantageously in oneor more computer programs that are executable on a programmable systemincluding at least one programmable processor coupled to receive dataand instructions from, and to transmit data and instructions to, a datastorage system, at least one input device, and at least one outputdevice. A computer program is a set of instructions that can be used,directly or indirectly, in a computer to perform a certain activity orbring about a certain result. A computer program can be written in anyform of programming language, including compiled or interpretedlanguages, and it can be deployed in any form, including as astand-alone program or as a module, component, subroutine, or other unitsuitable for use in a computing environment.

Suitable processors for the execution of a program of instructionsinclude, by way of example, both general and special purposemicroprocessors, and the sole processor or one of multiple processors ofany kind of computer. Generally, a processor will receive instructionsand data from a read-only memory or a random access memory or both. Theessential elements of a computer are a processor for executinginstructions and one or more memories for storing instructions and data.

Generally, a computer will also include, or be operatively coupled tocommunicate with, one or more mass storage devices for storing datafiles; such devices include magnetic disks, such as internal hard disksand removable disks; magneto-optical disks; and optical disks. Storagedevices suitable for tangibly embodying computer program instructionsand data include all forms of non-volatile memory, including by way ofexample semiconductor memory devices, such as EPROM, EEPROM, and flashmemory devices; magnetic disks such as internal hard disks and removabledisks; magneto-optical disks; and CD-ROM and DVD-ROM disks. Theprocessor and the memory can be supplemented by, or incorporated in,ASICs (application-specific integrated circuits).

To provide for interaction with a user, the features can be implementedon a computer having a display device such as a CRT (cathode ray tube)or LCD (liquid crystal display) monitor for displaying information tothe user and a keyboard and a pointing device such as a mouse or atrackball by which the user can provide input to the computer.

The features can be implemented in a computer system that includes aback-end component, such as a data server, or that includes a middlewarecomponent, such as an application server or an Internet server, or thatincludes a front-end component, such as a client computer having agraphical user interface or an Internet browser, or any combination ofthem. The components of the system can be connected by any form ormedium of digital data communication such as a communication network.Examples of communication networks include a local area network (“LAN”),a wide area network (“WAN”), peer-to-peer networks (having ad-hoc orstatic members), grid computing infrastructures, and the Internet.

The computer system can include clients and servers. A client and serverare generally remote from each other and typically interact through anetwork, such as the described one. The relationship of client andserver arises by virtue of computer programs running on the respectivecomputers and having a client-server relationship to each other.

A number of embodiments have been described. Nevertheless, it will beunderstood that various modifications may be made without departing fromthe spirit and scope of the invention. For example, much of thisdocument has been described with respect to defibrillators as medicaldevices, though other medical devices may employ the features describedhere. Also, although the modes described above are generally basic andadvanced modes, the modes could also be language specific, so thatportions of a display in one language could be lit in a first mode, andportions for a second language could be lit in a second mode, where theuser of a device may use a knob or touchscreen interface, or otherappropriate input mechanism, to select the desired mode. Also, differenttextual or graphical labels may be provided and swapped out in a device,so that the language for a device may be changed manually asappropriate.

Accordingly, other embodiments are within the scope of the followingclaims.

1-16. (canceled)
 17. A multi-mode electronic medical device forproviding resuscitative therapy, comprising: a device housing having afront side positioned to be visible to a user of the medical deviceduring use of the medical device; a user-selectable input to allow theuser to select between a basic life support mode and an advanced lifesupport mode for the medical device; a display on the front side of thedevice housing, the display configured to display a first set of textand/or graphics in the basic life support mode and to display a secondset of text and/or graphics, which are more complete than the first setof text and/or graphics, when the medical device is switched to theadvanced life support mode via the user-selectable input; and circuitryconfigured to control the display based on whether the medical device isoperating in the basic life support mode or the advanced life supportmode according to the user-selectable input.
 18. The medical device ofclaim 17, wherein the second set of text and/or graphics correspond toone or more features available to the user in the advanced life supportmode and unavailable to the user in the basic life support mode.
 19. Themedical device of claim 17, wherein the second set of text and/orgraphics visually depict at least one of: an electrocardiogram (ECG) ofa patient; a graph of cardiopulmonary resuscitation (CPR) chestcompressions administered to the patient; an elapsed time that CPR hasbeen performed with respect to the patient; a pulse of the patient; andinformation regarding one or more electrode pads applied to the patient.20. The medical device of claim 17, wherein the display is a touchscreendisplay.
 21. The medical device of claim 20, wherein the user-selectableinput is one or more buttons on the touchscreen display.
 22. The medicaldevice of claim 21, wherein the one or more buttons on the touchscreendisplay selects between the basic life support mode and the advancedlife support mode.
 23. The medical device of claim 17, wherein theuser-selectable input is a knob that is configured to be rotated by theuser in order to select between the basic life support mode and theadvanced life support mode.
 24. The medical device of claim 23, whereinthe display is a touchscreen display.
 25. The medical device of claim17, wherein the user-selectable input is a push button switch configuredto be depressed by the user in order to select between the basic lifesupport mode and the advanced life support mode.
 26. The medical deviceof claim 25, wherein the display is a touchscreen display.
 27. Themedical device of claim 17, wherein the medical device includes at leastone additional user selectable mode including a manual mode and a pacermode.
 28. The medical device of claim 17, wherein the circuitry isconfigured to hide certain notifications when the medical device isoperating in the basic life support mode and present the certainnotifications when the medical device is operating in the advanced lifesupport mode.
 29. The medical device of claim 28, wherein the certainnotifications are directed to warning associated with features onlyavailable in the advanced life support mode.
 30. The medical device ofclaim 17, further comprising: one or more additional control knobsdirected to pacing, a cover attached to the device housing andconfigured to conceal the one or more additional control knobs directedt pacing when the medical device is in the basic life support mode, andwherein the cover is configured to automatically open and reveal the oneor more additional control knobs in response to the medical device beingswitched to a pacing mode by the user.
 31. The medical device of claim30, wherein at least one of the one or more additional control knobsdirected to pacing corresponds to a power output associated withelectrodes attached to the medical device.
 32. The medical device ofclaim 30, wherein at least one of the one or more additional controlknobs directed to pacing corresponds to a pulse rate associated withelectrodes attached to the medical device.
 33. The medical device ofclaim 30, wherein the display is at least one of an LED (Light emittingdiode) display, an LCD (Liquid crystal display), and an OLED (organiclight-emitting diode) display.
 34. The medical device of claim 30,wherein the first set of text and/or graphics displayed in the basiclife support mode include wording of AED to indicate that the medicaldevice is operating as an automated external defibrillator.
 35. Themedical device of claim 30, wherein the second set of text and/orgraphics include at least one of: Lead, Size, Alarm Suspend, Recorder,Analyze, Charge, Energy Select, Pacer, and one or more arrows.